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Nse Ikpe Etim: All you should know about Adenomyosis

Over the weekend, Nollywood actress, Nse Ikpe-Etim opened up on why she has not had a kid and why she’s not going to have one, due to medical condition, Adenoymyosis, that she was diagnosed with.

The award-winning actress while speaking at an event tagged “Conversation With Nse” in Lagos said she won’t be able to have a kid because she has removed her womb.

She said she was diagnosed with Adenomyosis, a medical condition whereby the inner lining of the uterus breaks through the muscle wall of the uterus, three years ago.

In this featured post, we bring you details on Adenomyosis, the painful condition that affects one in 10 Women & No One Knows About It.

What is adenomyosis?

Like endometriosis, adenomyosis is a condition caused by tissue similar to the endometrium (the tissue in the lining of the womb) cropping up in places where it doesn’t belong. In endometriosis, this tissue occurs outside of the womb, whereas in adenomyosis it’s found between the muscle fibres in the uterine wall – the myometrium – which can cause painful and heavy periods, as well as pain during sex, urination and defecation.

How is it diagnosed?

This in itself is a relatively recent innovation, as Geeta Agnihotri, a consultant in maternal medicine, obstetrics and gynaecology, and spokesperson for charity Wellbeing of Women, explains: “Adenomyosis wasn’t recognised gynaecologically much in the past. It wasn’t really detected except after a woman had a hysterectomy, when the womb was taken away and looked at histologically (under a microscope).”

Today, she adds, the diagnosis can still only be confirmed histologically, but endometrial tissue between the muscle fibres of the womb can now be picked up on ultrasounds and MRI scans. Despite this, Agnihotri says, “adenomyosis is a coincidental finding in the majority of cases. It’s not usually something we were looking for.”

How common is it?

For obvious reasons, therefore, it’s difficult to get precise numbers on the prevalence of adenomyosis, but it’s thought to affect around one in 10 women.

The severity of symptoms varies, and about a third of women with adenomyosis won’t experience any symptoms at all.Adenomyosis is also believed to commonly coexist with other uterine conditions, like endometriosis or fibroids (non-cancerous growths found in the womb), as is the case for both Gemma and Jasmin. The Seckin Endometriosis Center in New York estimates that 40-50% of patients with adenomyosis are likely to have endometriosis, and 50% of patients with adenomyosis will also have cases of fibroids – but again, it’s tricky to know for sure.

When is it most likely to occur?

Adenomyosis can occur in anyone who has periods but is most common among women aged 40-50 and those who’ve had children – particularly, Dr Beckett says, “if you’ve had an operation like a Caesarean section which breaches the muscle wall of the womb.”For 58-year-old PR professional Caroline Ratner, adenomyosis symptoms didn’t kick in until shortly before the menopause.

“I was about 54, not yet menopausal, when it started – I literally didn’t stop bleeding, was in a lot of pain, and obviously also anaemic and exhausted,” Caroline says.”The GP just put me on progesterone, which did nothing, and told me it was all just part of the menopause.

The pain was hideous, and I got these terrible pains in my leg as well.”It wasn’t until a year and a half later that Caroline saw a specialist privately, who gave her an MRI scan. “He diagnosed adenomyosis and I had an ablation – a procedure that burns away the lining of the womb. It’s been absolutely fine since then, although that’s probably partly because I’ve now gone through the menopause,” she says.

How is it treated?

In terms of treatment options, Dr Beckett says: “I’d probably start with decent painkillers and things like mefenamic acid, an anti-inflammatory which reduces the amount of bleeding.”Second in line are hormonal treatments, such as the contraceptive pill – “particularly the mini (progesterone only) pill,” says Agnihotri, “which is brilliant because it thins out the lining of the womb” – or Mirena coil. Alternatively, Dr Beckett explains: “We can use GnRH analogues, which are a long-acting injection that cause a sort of temporary menopause.”

What to do if you’re concerned

If you’re concerned about any gynaecological symptoms, see your GP and don’t be afraid to ask for a second opinion if you’re not satisfied. “I think GPs are far less aware of adenomyosis than they are even about endometriosis.

It might have been just one little paragraph after endometriosis in the textbooks when they were at medical school,” says Dr Beckett.”You can always ask to be referred to a gynaecologist if you think your GP isn’t listening to you, and there are also GPs with a special interest in gynaecology who work in the community, so don’t take ‘no’ for an answer if your symptoms are bad,” she adds.”

If you’re flooding, if you’re passing clots bigger than a 50p piece, if you’re having to use a pad and a tampon, or double pads, if your period gets you up in the night – none of those things are normal.”

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